Ally Medical Group, P.a. P.C.

Organization Active NPI Developmental - Behavioral Pediatrics Physician · MC Lean, VA

NPI 1710711973 · NPPES record last updated Aug 29, 2024

Key facts

NPI
1710711973
Entity type
Organization (NPI type 2)
Primary specialty
Developmental - Behavioral Pediatrics Physician 2080P0006X
Legal business name
ALLY MEDICAL GROUP, P.A. P.C.
Practice address
1410 Spring Hill Rd Ste 305
MC Lean, VA 22102-3020
Phone
(240) 342-2666
NPI assigned
Aug 29, 2024
Organization subpart
No

Authorized official

Name
Lorraine Kabakama Beraho, MD
Title
Director
Phone
(301) 529-4927

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2080P0006X Yes

Addresses

Primary practice location

1410 Spring Hill Rd Ste 305
MC Lean, VA 22102-3020

Mailing address

1410 Spring Hill Rd Ste 305
MC Lean, VA 22102-3020

Other providers in MC Lean, VA

All providers in MC Lean, VA · Developmental - Behavioral Pediatrics Physician in Virginia

Sources for this page

Verify at the official NPI Registry.